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Duarte G, Braga AR, Kreitchmann R, Menezes MLB, Miranda AEB, Travassos AGA, Melli PPDS, Nomura RMY, da Silva AL, Wender MCO. Prevention, diagnosis, and treatment protocol of dengue during pregnancy and the postpartum period. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo73. [PMID: 38994458 PMCID: PMC11239217 DOI: 10.61622/rbgo/2024rbgo73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Affiliation(s)
- Geraldo Duarte
- Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo Ribeirão PretoSP Brazil Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonio Rodrigues Braga
- Faculdade de Medicina Universidade Federal do Rio de Janeiro Rio de JaneiroRJ Brazil Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Regis Kreitchmann
- Universidade Federal de Ciências da Saúde de Porto Alegre Porto AlegreRS Brazil Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maria Luiza Bezerra Menezes
- Faculdade de Ciências Médicas Universidade de Pernambuco RecifePE Brazil Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brazil
| | - Angélica Espinosa Barbosa Miranda
- Faculdade de Medicina Universidade Federal do Espírito Santo VitóriaES Brazil Faculdade de Medicina, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Ana Gabriela Alvares Travassos
- Faculdade de Medicina Universidade do Estado da Bahia SalvadorBA Brazil Faculdade de Medicina, Universidade do Estado da Bahia, Salvador, BA, Brazil
| | - Patrícia Pereira Dos Santos Melli
- Hospital das Clínicas Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo Ribeirão PretoSP Brazil Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Roseli Mieko Yamamoto Nomura
- Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Faculdade de Medicina Universidade de São Paulo São PauloSP Brazil Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Agnaldo Lopes da Silva
- Universidade Federal de Minas Gerais Belo HorizonteMG Brazil Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria Celeste Osório Wender
- Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Symptomatic Chikungunya Virus Infection and Pregnancy Outcomes: A Nested Case-Control Study in French Guiana. Viruses 2022; 14:v14122705. [PMID: 36560712 PMCID: PMC9787529 DOI: 10.3390/v14122705] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/07/2022] Open
Abstract
During the Chikungunya epidemic in the Caribbean and Latin America, pregnant women were affected by the virus in French Guiana. The question of the impact of the virus on pregnancy was raised because of the lack of scientific consensus and published data in the region. Thus, during the Chikungunya outbreak in French Guiana, a comparative study was set up using a cohort of pregnant women. The objective was to compare pregnancy and neonatal outcomes between pregnant women with Chikungunya virus (CHIKV) infection and pregnant women without CHIKV. Of 653 mothers included in the cohort, 246 mothers were included in the case-control study: 73 had CHIKV fever during pregnancy and 173 had neither fever nor CHIKV during pregnancy. The study did not observe any severe clinical presentation of CHIKV in the participating women. There were no intensive care unit admissions. In addition, the study showed no significant difference between the two groups with regard to pregnancy complications. However, the results showed a potential excess risk of neonatal ICU admission of the newborn when the maternal infection occurred within 7 days before delivery. These results suggest that special attention should be paid to neonates whose mothers were infected with CHIKV shortly before delivery.
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Osoro E, Inwani I, Mugo C, Hunsperger E, Verani JR, Omballa V, Wamalwa D, Rhee C, Nduati R, Kinuthia J, Jin H, Okutoyi L, Mwaengo D, Maugo B, Otieno NA, Mirieri H, Shabibi M, Munyua P, Njenga MK, Widdowson MA. Prevalence of microcephaly and Zika virus infection in a pregnancy cohort in Kenya, 2017-2019. BMC Med 2022; 20:291. [PMID: 36100910 PMCID: PMC9470235 DOI: 10.1186/s12916-022-02498-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV), first discovered in Uganda in 1947, re-emerged globally in 2013 and was later associated with microcephaly and other birth defects. We determined the incidence of ZIKV infection and its association with adverse pregnancy and fetal outcomes in a pregnancy cohort in Kenya. METHODS From October 2017 to July 2019, we recruited and followed up women aged ≥ 15 years and ≤ 28 weeks pregnant in three hospitals in coastal Mombasa. Monthly follow-up included risk factor questions and a blood sample collected for ZIKV serology. We collected anthropometric measures (including head circumference), cord blood, venous blood from newborns, and any evidence of birth defects. Microcephaly was defined as a head circumference (HC) < 2 standard deviations (SD) for sex and gestational age. Severe microcephaly was defined as HC < 3 SD for sex and age. We tested sera for anti-ZIKV IgM antibodies using capture enzyme-linked immunosorbent assay (ELISA) and confirmed positives using the plaque reduction neutralization test (PRNT90) for ZIKV and for dengue (DENV) on the samples that were ZIKV neutralizing antibody positive. We collected blood and urine from participants reporting fever or rash for ZIKV testing. RESULTS Of 2889 pregnant women screened for eligibility, 2312 (80%) were enrolled. Of 1916 recorded deliveries, 1816 (94.6%) were live births and 100 (5.2%) were either stillbirths or spontaneous abortions (< 22 weeks of gestation). Among 1236 newborns with complete anthropometric measures, 11 (0.9%) had microcephaly and 3 (0.2%) had severe microcephaly. A total of 166 (7.2%) participants were positive for anti-ZIKV IgM, 136 of whom became seropositive during follow-up. Among the 166 anti-ZIKV IgM positive, 3 and 18 participants were further seropositive for ZIKV and DENV neutralizing antibodies, respectively. Of these 3 and 18 pregnant women, one and 13 (72.2%) seroconverted with antibodies to ZIKV and DENV, respectively. All 308 samples (serum and urine samples collected during sick visits and samples that were anti-ZIKV IgM positive) tested by RT-PCR were negative for ZIKV. No adverse pregnancy or neonatal outcomes were reported among the three participants with confirmed ZIKV exposure. Among newborns from pregnant women with DENV exposure, four (22.2%) were small for gestational age and one (5.6%) had microcephaly. CONCLUSIONS The prevalence of severe microcephaly among newborns in coastal Kenya was high relative to published estimates from facility-based studies in Europe and Latin America, but little evidence of ZIKV transmission. There is a need for improved surveillance for microcephaly and other congenital malformations in Kenya.
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Affiliation(s)
- Eric Osoro
- Washington State University Global Health Kenya, One Padmore Place, George Padmore Road, Off Ngong Road, Nairobi, Kenya. .,Paul G. Allen School of Global Health, Washington State University, Pullman, USA.
| | - Irene Inwani
- Department of Pediatrics and Child Health/Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | - Cyrus Mugo
- Department of Pediatrics and Child Health/Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | - Elizabeth Hunsperger
- Division of Global Health Protection, Centers for Disease Control and Prevention, CDC Kenya, Nairobi, Kenya
| | - Jennifer R Verani
- Division of Global Health Protection, Centers for Disease Control and Prevention, CDC Kenya, Nairobi, Kenya
| | - Victor Omballa
- Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Dalton Wamalwa
- Department of Pediatrics and Child Health/Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | - Chulwoo Rhee
- Division of Global Health Protection, CentersforDiseaseControlandPrevention, Atlanta, USA
| | - Ruth Nduati
- Department of Pediatrics and Child Health/Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | - John Kinuthia
- Research and Programs Department, Kenyatta National Hospital/University of Nairobi, Nairobi, Kenya
| | - Hafsa Jin
- Coast General Hospital, Mombasa, Kenya
| | - Lydia Okutoyi
- Department of Obstetrics and Gynecology/Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | - Dufton Mwaengo
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Brian Maugo
- Department of Pediatrics and Child Health/Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | - Nancy A Otieno
- Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Harriet Mirieri
- Washington State University Global Health Kenya, One Padmore Place, George Padmore Road, Off Ngong Road, Nairobi, Kenya
| | | | - Peninah Munyua
- Division of Global Health Protection, Centers for Disease Control and Prevention, CDC Kenya, Nairobi, Kenya
| | - M Kariuki Njenga
- Washington State University Global Health Kenya, One Padmore Place, George Padmore Road, Off Ngong Road, Nairobi, Kenya.,Paul G. Allen School of Global Health, Washington State University, Pullman, USA
| | - Marc-Alain Widdowson
- Division of Global Health Protection, Centers for Disease Control and Prevention, CDC Kenya, Nairobi, Kenya.,Institute of Tropical Medicine, Antwerp, Belgium
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Dussault JM, Paz-Bailey G, Sánchez-González L, Adams LE, Rodríguez DM, Ryff KR, Major CG, Lorenzi O, Rivera-Amill V. Arbovirus risk perception as a predictor of mosquito-bite preventive behaviors in Ponce, Puerto Rico. PLoS Negl Trop Dis 2022; 16:e0010653. [PMID: 35881642 PMCID: PMC9355236 DOI: 10.1371/journal.pntd.0010653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 08/05/2022] [Accepted: 07/11/2022] [Indexed: 11/27/2022] Open
Abstract
Mosquito-borne arboviruses are an important cause of morbidity and mortality in the Caribbean. In Puerto Rico, chikungunya, dengue, and Zika viruses have each caused large outbreaks during 2010-2022. To date, the majority of control measures to prevent these diseases focus on mosquito control and many require community participation. In 2018, the U.S. Centers for Disease Control and Prevention launched the COPA project, a community-based cohort study in Ponce, Puerto Rico, to measure the impact of novel vector control interventions in reducing arboviral infections. Randomly selected households from 38 designated cluster areas were offered participation, and baseline data were collected from 2,353 households between May 2018 and May 2019. Household-level responses were provided by one representative per home. Cross-sectional analyses of baseline data were conducted to estimate 1) the association between arboviral risk perception and annual household expenditure on mosquito control, and 2) the association between arboviral risk perception and engagement in ≥3 household-level risk reduction behaviors. In this study, 27% of household representatives believed their household was at high risk of arboviruses and 36% of households engaged in at least three of the six household-level preventive behaviors. Households where the representative perceived their household at high risk spent an average of $35.9 (95% confidence interval: $23.7, $48.1) more annually on mosquito bite prevention compared to households where the representative perceived no risk. The probability of engaging in ≥3 household-level mosquito-preventive behaviors was 10.2 percentage points greater (7.2, 13.0) in households where the representatives perceived high risk compared to those in which the representatives perceived no risk. Paired with other research, these results support investment in community-based participatory approaches to mosquito control and providing accessible information for communities to accurately interpret their risk.
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Affiliation(s)
- Josée M. Dussault
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Gabriela Paz-Bailey
- Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Liliana Sánchez-González
- Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Laura E. Adams
- Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Dania M. Rodríguez
- Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Kyle R. Ryff
- Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Chelsea G. Major
- Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Olga Lorenzi
- Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
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Placental Alterations in a Chikungunya-Virus-Infected Pregnant Woman: A Case Report. Microorganisms 2022; 10:microorganisms10050872. [PMID: 35630317 PMCID: PMC9144120 DOI: 10.3390/microorganisms10050872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
Chikungunya virus (CHIKV) is an arthropod-borne virus first isolated in Tanzania, Africa. The virus has spread to Asia as well as South and Central America through infected Aedes mosquitoes. Vertical transmission may also occur, and was first documented during a chikungunya outbreak in La Réunion Island in 2005. Since then, some authors have been discussing the role of the placenta in maternal–fetal CHIKV transmission. CHIKV infection is characterized by fever, headache, rash, and arthralgia. However, atypical manifestations and clinical complications, including neurological, cardiac, renal, ocular, and dermal, may occur in some cases. In this report, we describe the case of a pregnant woman infected by CHIKV during the third trimester of gestation, who presented with severe dermatological manifestations during the epidemic in Rio de Janeiro, Brazil in 2019. CHIKV RNA and antigens were detected in the placental tissue, which presented with histopathological (deciduitis, fibrin deposition, edema, fetal vessel thickening, and chorioamnionitis) and ultrastructural alterations (cytotrophoblast with mitochondrial swelling and dilated cisterns in endoplasmic reticulum, vesicles in syncytiotrophoblasts, and thickening of the basement membrane of the endothelium).
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Surveillance for Common Arboviruses in Whole Blood of Malaria-Free Ill Returned Canadian Travelers to the Americas. Curr Infect Dis Rep 2021. [DOI: 10.1007/s11908-021-00762-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fajardo TCG, Gazeta RE, Catalan DT, Mello AS, da Silva ACB, Bertozzi APAP, Santos GRD, Pinto CAL, Monteiro CO, Machado RRG, Oliveira DBL, Durigon EL, Passos SD. Neonatal consequences of maternal exposure to the chikungunya virus: Case reports. Medicine (Baltimore) 2021; 100:e25695. [PMID: 33907147 PMCID: PMC8084008 DOI: 10.1097/md.0000000000025695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
RATIONALE The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV. PATIENT CONCERNS In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth. DIAGNOSIS In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children. INTERVENTIONS The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection. OUTCOMES There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth. LESSONS Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Cairo Oliveira Monteiro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Saulo Duarte Passos
- Laboratory of Paediatric Infectology, Jundiaí School of Medicine
- Department of Paediatric, Jundiaí School of Medicine
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Ginige S, Flower R, Viennet E. Neonatal Outcomes From Arboviruses in the Perinatal Period: A State-of-the-Art Review. Pediatrics 2021; 147:peds.2020-009720. [PMID: 33737375 DOI: 10.1542/peds.2020-009720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/24/2022] Open
Abstract
Since the 2016 Zika outbreak and the understanding of the teratogenic effect of this infection, there has been a newfound interest in arbovirus infections and their effects on pregnancy, resulting in numerous publications in the last 5 years. However, limited literature focuses on arbovirus infection in different stages of pregnancy and their effect on the neonate. There is currently no consensus management of perinatal acquisition of arboviruses, and current evidence is largely anecdotal observational reports. Teratogens can have different effects on the developing fetus depending on the time of infection, so infections during pregnancy should be analyzed by trimester. A better understanding of arbovirus infection in the perinatal period is required to assist obstetric, neonatal, and pediatric clinicians in making decisions about the management of mother and neonate. Our objective was to assess the evidence of adverse neonatal outcomes for several arboviral infections when contracted during the perinatal period to guide clinicians in managing these patients. There are 8 arboviruses for which neonatal outcomes from maternal acquisition in the perinatal period have been reported, with the most data for dengue and Chikungunya virus infections. The evidence reviewed in this article supports the adoption of preventive strategies to avoid ticks and mosquitoes close to the date of delivery. For the other arbovirus infections, further community-based cohort studies during outbreaks are required to evaluate whether these infections have a similar teratogenic impact.
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Santos GPG, Gouveia MTDO, Costa RMPG, Santos AMRD, Avelino FVSD. Effects in the development of children exposed to zika virus in the fetal period: an integrative review. Rev Bras Enferm 2020; 73:e20190883. [PMID: 33206852 DOI: 10.1590/0034-7167-2019-0883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/18/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To know the evidence available in the literature on the effects of the zika virus in children development after fetal exposure. METHODS This is an integrative literature review with 16 scientific articles found in five databases (PubMed, LILACS, CINAHL, Web of Science and Scopus), based on the guiding question: "What are the effects in the development of children aged 0 to 6 years exposed to the zika virus in the fetal period? The STROBE statement was used for data extraction and evaluation of primary studies. RESULTS Exposure to the zika virus in the fetal period resulted in several congenital anomalies and/or changes in the central nervous system: microcephaly, ocular problems, neurosensorial problems, ventriculomegaly, intracranial calcification, cardiopathy, arthrogryposis, among others. CONCLUSION The zika virus is neurotropic; its effect in the fetal nervous system causes irreparable damage to the child, so health professionals, especially nurses, must intensify maternal and also childcare.
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da Silva FC, Magaldi FM, Sato HK, Bevilacqua E. Yellow Fever Vaccination in a Mouse Model Is Associated With Uninterrupted Pregnancies and Viable Neonates Except When Administered at Implantation Period. Front Microbiol 2020; 11:245. [PMID: 32153534 PMCID: PMC7044120 DOI: 10.3389/fmicb.2020.00245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 02/03/2020] [Indexed: 02/05/2023] Open
Abstract
The potential risk of yellow fever (YF) infection in unvaccinated pregnant women has aroused serious concerns. In this study, we evaluated the effect of the YF vaccine during gestation using a mouse model, analyzing placental structure, immunolocalization of the virus antigen, and viral activity at the maternal-fetal barrier and in the maternal liver and fetus. The YF vaccine (17DD) was administered subcutaneously at a dose of 2.0 log10 PFU to CD-1 mice on gestational days (gd) 0.5, 5.5, and 11.5 (n = 5–10/group). The control group received sterile saline (n = 5–10/group). Maternal liver, implantation sites with fetus, and placentas were collected on gd18.5. The numbers of implantation sites, reabsorbed embryos, and stillborn fetuses were counted, and placentas and live fetuses were weighed. Tissues (placenta, fetuses, and liver) of vaccinated pregnant mice on gd5.5 (n = 15) were paraffin-embedded in 10% buffered-formalin and collected in TRIzol for immunolocalization of YF vaccine virus and PCR, respectively. PCR products were also subjected to automated sequence analysis. Fetal growth restriction (p < 0.0001) and a significant decrease in fetal viability (p < 0.0001) occurred only when the vaccine was administered on gd5.5. In stillbirths, the viral antigen was consistently immunolocalized at the maternal-fetal barrier and in fetal organs, suggesting a transplacental transfer. In stillbirths, RNA of the vaccine virus was also detected by reverse transcriptase-PCR indicating viral activity in the maternal liver and fetal tissues. In conclusion, the findings of this study in the mouse suggest that vaccination did not cause adverse outcomes with respect to fetal development except when administered during the early gestational stage, indicating the implantation period as a susceptible period in which the YF vaccine virus might interfere with pregnancy.
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Affiliation(s)
- Fernanda C da Silva
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Fernanda M Magaldi
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Helena K Sato
- Secretaria do Estado de São Paulo, Epidemiological Surveillance Center, Department of Health, São Paulo, Brazil
| | - Estela Bevilacqua
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Krubiner CB, Schwartz DA. Viral Hemorrhagic Fevers in Pregnant Women and the Vaccine Landscape: Comparisons Between Yellow Fever, Ebola, and Lassa Fever. CURRENT TROPICAL MEDICINE REPORTS 2019. [DOI: 10.1007/s40475-019-00194-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Vertically transmitted chikungunya, Zika and dengue virus infections: The pathogenesis from mother to fetus and the implications of co-infections and vaccine development. Int J Pediatr Adolesc Med 2019; 7:107-111. [PMID: 33094137 PMCID: PMC7567994 DOI: 10.1016/j.ijpam.2019.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/01/2019] [Accepted: 05/26/2019] [Indexed: 01/23/2023]
Abstract
Chikungunya (CHIKV), Zika (ZIKV), and Dengue viruses (DENV) exhibit similar epidemiological and clinical patterns but have different pathophysiological mechanisms of disease manifestations. Differences occur in the severity of clinical presentations with the highest mortality in the general population attributed to DENV and neurological morbidity due to ZIKV. ZIKV and DENV infections can cause fetal loss with ZIKV exhibiting teratogenesis. CHIKV is associated with severe complications in the newborn. Co-circulation of the three viruses and the cross-reactive immune response between ZIKV and DENV viruses has implications for an attenuated clinical response and future vaccine development. Co-infections could increase due to the epidemiologic synergy, but there is limited evidence about the clinical effects, especially for the vulnerable newborn. The purpose of this paper is to review the pathophysiological basis for vertically transmission manifestations due to CHIKV, DENV, and ZIKV, to determine the potential effects of co-circulation on newborn outcomes and the potential for vaccine protection. Inflammatory cytokines are responsible for placental breaches in DENV and ZIKV; Hofbauer cells facilitate the transfer of ZIKV from the placenta to the fetal brain, and high viral loads and mechanical placental disruption facilitate the transmission of CHIKV. Co-infection of these viruses can present with severe manifestations, but the clinical and serologic evidence suggests that one virus predominates which may influence fetal transmission. All three viruses are in different stages of vaccine development with DENV vaccine being fully licensed. Antibody-enhanced infections in seronegative vaccinated candidates who develop natural infection to dengue limit its use and have implications for ZIKV vaccine development. Targeting transmission capacity in the vector could prevent transmission to all three viruses, and breast milk immunity could provide further clues for vaccine development.
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Atovaquone Inhibits Arbovirus Replication through the Depletion of Intracellular Nucleotides. J Virol 2019; 93:JVI.00389-19. [PMID: 30894466 DOI: 10.1128/jvi.00389-19] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/13/2019] [Indexed: 12/11/2022] Open
Abstract
Arthropod-borne viruses represent a significant public health threat worldwide, yet there are few antiviral therapies or prophylaxes targeting these pathogens. In particular, the development of novel antivirals for high-risk populations such as pregnant women is essential to prevent devastating disease such as that which was experienced with the recent outbreak of Zika virus (ZIKV) in the Americas. One potential avenue to identify new and pregnancy-acceptable antiviral compounds is to repurpose well-known and widely used FDA-approved drugs. In this study, we addressed the antiviral role of atovaquone, an FDA Pregnancy Category C drug and pyrimidine biosynthesis inhibitor used for the prevention and treatment of parasitic infections. We found that atovaquone was able to inhibit ZIKV and chikungunya virus virion production in human cells and that this antiviral effect occurred early during infection at the initial steps of viral RNA replication. Moreover, we were able to complement viral replication and virion production with the addition of exogenous pyrimidine nucleosides, indicating that atovaquone functions through the inhibition of the pyrimidine biosynthesis pathway to inhibit viral replication. Finally, using an ex vivo human placental tissue model, we found that atovaquone could limit ZIKV infection in a dose-dependent manner, providing evidence that atovaquone may function as an antiviral in humans. Taken together, these studies suggest that atovaquone could be a broad-spectrum antiviral drug and a potential attractive candidate for the prophylaxis or treatment of arbovirus infection in vulnerable populations, such as pregnant women and children.IMPORTANCE The ability to protect vulnerable populations such as pregnant women and children from Zika virus and other arbovirus infections is essential to preventing the devastating complications induced by these viruses. One class of antiviral therapies may lie in known pregnancy-acceptable drugs that have the potential to mitigate arbovirus infections and disease, yet this has not been explored in detail. In this study, we show that the common antiparasitic drug atovaquone inhibits arbovirus replication through intracellular nucleotide depletion and can impair ZIKV infection in an ex vivo human placental explant model. Our study provides a novel function for atovaquone and highlights that the rediscovery of pregnancy-acceptable drugs with potential antiviral effects can be the key to better addressing the immediate need for treating viral infections and preventing potential birth complications and future disease.
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The BeWo cell line derived from a human placental choriocarcinoma is permissive for respiratory syncytial virus infection. Virus Genes 2019; 55:406-410. [PMID: 30758769 DOI: 10.1007/s11262-019-01646-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 02/04/2019] [Indexed: 12/17/2022]
Abstract
The respiratory syncytial virus (RSV) is the main pathogen associated with upper respiratory tract infections during early childhood. Vertical transmission of this virus has been suggested in humans, based on observations recorded during animal studies that revealed an association of RSV with persistent structural and functional changes in the developing lungs of the offspring. However, human placentas have not yet been evaluated for susceptibility to RSV infection. In this study, we examined the capacity of RSV to infect a human trophoblast model, the BeWo cell line. Our results suggest that BeWo cells are susceptible to RSV infection since they allow RNA viral replication, viral protein translation, leading to the production of infectious RSV particles. In this report, we demonstrate that a human placenta model system, consisting of BeWo cells, is permissive to RSV infection. Thus, the BeWo cell line may represent a useful model for studies that aim to characterize the events of a possible RSV infection at the human maternal-fetal interface.
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15
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Cardoso TF, Santos RSD, Corrêa RM, Campos JV, Silva RDB, Tobias CC, Prata-Barbosa A, Cunha AJLAD, Ferreira HC. Congenital Zika infection: neurology can occur without microcephaly. Arch Dis Child 2019; 104:199-200. [PMID: 29858269 DOI: 10.1136/archdischild-2018-314782] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Taíssa Ferreira Cardoso
- Postgraduate Program in Perinatal Health Care, Maternidade Escola, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Rosana Silva Dos Santos
- Department of Physical Therapy, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ) and Program in Perinatal Health Care, Maternidade Escola, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Raquel Miranda Corrêa
- Maternidade Escola, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Juliana Vieira Campos
- Postgraduate Program in Perinatal Health Care, Maternidade Escola, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ricardo de Bastos Silva
- Physical Therapy Course, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Arnaldo Prata-Barbosa
- Department of Pediatrics, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ) and D'Or Institute for Research & Education (IDOR), Rio de Janeiro, Brazil
| | - Antonio José Ledo Alves da Cunha
- Department of Pediatrics, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ) and D'Or Institute for Research & Education (IDOR), Rio de Janeiro, Brazil
| | - Halina Cidrini Ferreira
- Department of Physical Therapy, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ) and Program in Perinatal Health Care, Maternidade Escola, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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16
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Merle H, Donnio A, Jean-Charles A, Guyomarch J, Hage R, Najioullah F, Césaire R, Cabié A. [Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever (French translation of the article)]. J Fr Ophtalmol 2018; 41:659-668. [PMID: 30173871 DOI: 10.1016/j.jfo.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/04/2018] [Accepted: 03/05/2018] [Indexed: 01/12/2023]
Abstract
Arboviruses are viral diseases transmitted by mosquitoes and tics bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.
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Affiliation(s)
- H Merle
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France.
| | - A Donnio
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - A Jean-Charles
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - J Guyomarch
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - R Hage
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - F Najioullah
- EA4537, Inserm CIC 1424, laboratoire de virologie, université des Antilles, France
| | - R Césaire
- EA4537, Inserm CIC 1424, laboratoire de virologie, université des Antilles, France
| | - A Cabié
- EA4537, Inserm CIC 1424, service des maladies infectieuses et tropicales, université des Antilles, France
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17
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Merle H, Donnio A, Jean-Charles A, Guyomarch J, Hage R, Najioullah F, Césaire R, Cabié A. Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever. J Fr Ophtalmol 2018; 41:e235-e243. [PMID: 29929827 DOI: 10.1016/j.jfo.2018.05.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 04/30/2018] [Accepted: 05/16/2018] [Indexed: 10/28/2022]
Abstract
Arboviruses are viral diseases transmitted by mosquitoes and tick bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.
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Affiliation(s)
- H Merle
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France.
| | - A Donnio
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - A Jean-Charles
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - J Guyomarch
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - R Hage
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - F Najioullah
- Virology Laboratory, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - R Césaire
- Virology Laboratory, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - A Cabié
- EA4537, INSERM CIC 1424, Tropical and Infectious Disease Service, University of the Antilles, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France
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18
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Alvarado-Socarras JL, Idrovo ÁJ, Contreras-García GA, Rodriguez-Morales AJ, Audcent TA, Mogollon-Mendoza AC, Paniz-Mondolfi A. Congenital microcephaly: A diagnostic challenge during Zika epidemics. Travel Med Infect Dis 2018; 23:14-20. [PMID: 29471046 DOI: 10.1016/j.tmaid.2018.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 02/02/2018] [Accepted: 02/13/2018] [Indexed: 01/01/2023]
Abstract
The multiple, wide and diverse etiologies of congenital microcephaly are complex and multifactorial. Recent advances in genetic testing have improved understanding of novel genetic causes of congenital microcephaly. The recent Zika virus (ZIKV) epidemic in Latin America has highlighted the need for a better understanding of the underlying pathological mechanisms of microcephaly including both infectious and non-infectious causes. The diagnostic approach to microcephaly needs to include potential infectious and genetic etiologies, as well as environmental in-utero exposures such as alcohol, toxins, and medications. Emerging genetic alterations linked to microcephaly include abnormal mitotic microtubule spindle structure and abnormal function of centrosomes. We discuss the diagnostic challenge of congenital microcephaly in the context of understanding the links with ZIKV emergence as a new etiological factor involved in this birth defect.
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Affiliation(s)
- Jorge L Alvarado-Socarras
- Neonatal Unit, Department of Pediatrics, Fundación Cardiovascular de Colombia, Floridablanca, Santander, Colombia; Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), Bucaramanga, Santander, Colombia; Colombian Collaborative Network on Zika (RECOLZIKA), Pereira, Risaralda, Colombia
| | - Álvaro J Idrovo
- Public Health Department, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Colombia
| | | | - Alfonso J Rodriguez-Morales
- Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), Bucaramanga, Santander, Colombia; Colombian Collaborative Network on Zika (RECOLZIKA), Pereira, Risaralda, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
| | - Tobey A Audcent
- Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Adriana C Mogollon-Mendoza
- Infectious Diseases Research Incubator and the Zoonosis and Emerging Pathogens Regional Collaborative Network, Venezuela; Health Sciences Department, College of Medicine, Universidad Centroccidental Lisandro Alvarado, Barquisimeto, Lara, Venezuela
| | - Alberto Paniz-Mondolfi
- IDB Biomedical Research Center, Department of Infectious Diseases and Tropical Medicine/Infectious Diseases Pathology Laboratory (IDB), Barquisimeto, Venezuela; Directorate of Health, Instituto Venezolano de Los Seguros Sociales (IVSS), Caracas, Dtto. Capital, Venezuela
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19
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Rawlinson W. Arboviruses in pregnancy: consequences of maternal and fetal infection. MICROBIOLOGY AUSTRALIA 2018. [DOI: 10.1071/ma18028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Epidemics and localised outbreaks of infections due to arthropod borne (arbo) viruses, have been described for hundreds of years. Few viruses to date are known to transmit from mother to fetus, causing either teratogenic effects or fetal demise (see recent reviews Charlier et al.1 and Marinho et al.2). Many arboviruses are zoonotic but there appear to be few parallels between the effect of these viruses following human or animal infection during pregnancy. Higher rates of MTCT (mother to child transmission) may be seen (1) where herd immunity is reduced, either because virus is newly introduced into a population (as occurred in Brazil with ZIKV), or where the virus has only recently become endemic (as occurred with West Nile virus (WNV) in the USA in the 1990s), (2) where the arthropod vector is present, (3) where the vector transmits virus efficiently, and (4) in groups of pregnant women exposed, allowing transmission3.
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